Reimbursement
Pennsylvania backs off co-payment plan; Texas investigates dental fraud; Alaska to study costs of Medicaid expansion in this week's Medicaid Digest.
State Medicaid directors are caught in the vice grip of competing interests driven by the looming election, lean state budgets, uncertainty about expansion caused by the Supreme Court health reform decision and the threat that Congress will cut the health program to help balance the federal budget.
Not surprisingly, only about 10% of firms with fewer than 200 workers take advantage of self-insurance -- and almost no very small groups (fewer than 50 workers) use the product. It just isn't worth it for these small employer groups to take the risk that they will either have too many claims or very big claims from their workers -- that is what insurance companies are for.
Private health insurance exchanges are sprouting up and established ones want to grow, challenging state-based HIXs and expanding the retail insurance market.
The Medicare program could save billions in the next decade if care models are restructured says a newly released analysis commissioned by a nonprofit, national consortium of home healthcare organizations.
Susan Turney, MD, took the helm as president and CEO of the Medical Group Management Association one year ago on Oct. 12, succeeding William Jessee, MD, who retired after 12 years.
A number of states will partner with the federal government to get their health insurance exchanges up and running, at least initially, because they were unable -- for political or timing reasons -- to get authority or plans ready by an imminent deadline.
October 1 was the deadline for states to submit their essential health benefit plans to the Department of Health and Human Services -- a "soft deadline," the agency has said.
The findings of a new study underscore the positive correlation between high quality care in physician practices and the use of electronic health records (EHRs). Experts say the study is one of the first to examine and subsequently validate the clinical value of EHRs.
The Citizens' Counsel for Health Freedom (CCHF) has added its voice to those of four Republican lawmakers who recently called for a temporary halt to meaningful use incentives until the program is revamped.